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Peter M Sadow - One of the best experts on this subject based on the ideXlab platform.

  • noninvasive follicular Thyroid Neoplasm with papillary like nuclear features niftp diagnostic updates and molecular advances
    Seminars in Diagnostic Pathology, 2020
    Co-Authors: Yinghsia Chu, Peter M Sadow
    Abstract:

    Abstract The noninvasive follicular Thyroid Neoplasm with papillary-like nuclear features (NIFTP) is a strictly defined Thyroid lesion, reclassified in 2016, in order to more accurately reflect the biological behavior of the tumor and thus, modify the way the lesion is clinically approached and perceived both by practitioners and patients. Additionally, this newly specified designation also allows for more uniformity in reporting for general pathologists less comfortable to exclude overt malignancy with certain nuclear features. In recent years, increasing molecular analyses correlated with longitudinal clinical outcomes have fostered improved diagnostic and treatment paradigms. Important revisions made to the definition of NIFTP in 2018 include the prohibition of any true papillae formation and the exclusion of lesions harboring the BRAF V600E mutation and other high-risk genetic abnormalities. These changes reflect the imperfection of the current criteria in outcome prediction and the global efforts for improvement. NIFTP are lesions with a wide range of size and cytomorphology. Although not addressed in the original series, large (≥4 cm) and oncocytic NIFTP have recently been shown to incur no recurrence or metastatic risk. Molecularly, NIFTP have a similar mutational profile as other follicular Thyroid Neoplasms, with frequent RAS family mutations and PAX8-PPARɤ fusions. However, the transcriptomic landscape is highly heterogenous, adding difficulty to gene expression-based cytopathologic classification. This review summarizes the evolution of the NIFTP concept and important advances in recent literature.

  • exploration of brafv600e as a diagnostic adjuvant in the non invasive follicular Thyroid Neoplasm with papillary like nuclear features niftp
    Human Pathology, 2018
    Co-Authors: Daniel Johnson, Peter M Sadow
    Abstract:

    Summary The non-invasive follicular Thyroid Neoplasm with papillary-like nuclear features (NIFTP) and encapsulated follicular variant of papillary Thyroid carcinoma (EFVPTC) are distinguished from classical papillary Thyroid carcinoma with predominantly follicular architecture (CPTCPFA) by distinct histomorphologic and molecular features. CPTCPFA frequently harbor the oncogenic variant BRAFV600E while NIFTP and EFVPTC are largely RAS driven. CPTCPFA have rare papillae and intranuclear pseudoinclusions that may distinguish them from NIFTP or EFVPTC. We evaluated for BRAFV600E mutation using mutation-specific BRAF (VE1) antibody immunohistochemistry (BRAFVE) as part of an immunomorphologic tumor panel, often including HBME1, for follicular-patterned lesions with nuclear atypia. An archival search identified cases of NIFTP, CPTCPFA, or EFVPTC between 2015–2017, and demographic data, tumor characteristics, molecular data, and metastases were documented. Our search yielded 275 tumors across categories, and 208 were tested with BRAFVE. Sixty-one NIFTP and 31 sub-centimeter NIFTP were tested, and none (0/92) were positive for BRAFVE. Nineteen CPTCPFA and 14 sub-centimeter CPTCPFA were tested with 18 of 33 (54.5%) BRAFVE positive. Sixty-one EFVPTC and 21 sub-centimeter EFVPTC were tested, with 12 of 81 (14.8%) positive. Mean follow-up time was 1.5 years. Six (4.6%) patients with concurrent classical papillary Thyroid carcinoma had local lymph node metastases at time of NIFTP diagnosis, as did 15 of 111 (13.5%) EFVPTC. Six of 34 (14.7%) CPTCPFA had local nodal metastases with five being considered the primary lesion. One EFVPTC (0.9%), BRAFVE negative, metastasized to femur. The findings indicate that BRAFVE used in conjunction with routine sampling of follicular-patterned tumors is a useful diagnostic adjuvant.

  • noninvasive follicular Thyroid Neoplasm with papillary like nuclear features a review for pathologists
    Modern Pathology, 2018
    Co-Authors: Raja R Seethala, Yuri E Nikiforov, Giovanni Tallini, Peter M Sadow, Zubair W. Baloch, Justine A Barletta, Elham Khanafshar, Ozgur Mete, Virginia A Livolsi, Lester D R Thompson
    Abstract:

    Noninvasive follicular Thyroid Neoplasm with papillary-like nuclear features: a review for pathologists

  • Noninvasive follicular Thyroid Neoplasm with papillary-like nuclear features: a review for pathologists
    Modern Pathology, 2018
    Co-Authors: Raja R Seethala, Yuri E Nikiforov, Giovanni Tallini, Peter M Sadow, Zubair W. Baloch, Justine A Barletta, Elham Khanafshar, Ozgur Mete, Virginia A Livolsi, Lester D R Thompson
    Abstract:

    The rising incidence of papillary Thyroid carcinoma is linked in part to inclusion of noninvasive follicular variant of papillary Thyroid carcinoma. Despite its designation as carcinoma , noninvasive follicular variant of papillary Thyroid carcinoma appears to be exceptionally indolent, often over treated by current treatment practices. Additionally, criteria for diagnosis have historically been subjective and challenging. Recently, an international multidisciplinary collaborative group performed a clinicopathologic survey of such cases with extended follow-up and concluded based on the outcome data that a revision in nomenclature was warranted, proposing ‘Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP).’ This monograph is a synopsis and guide for pathologists on NIFTP and focuses on histologic features, including inclusion and exclusion criteria used to define NIFTP, as well as grossing guidelines, reporting practices, and potential diagnostic limitations.

  • evaluating the projected surgical impact of reclassifying noninvasive encapsulated follicular variant of papillary Thyroid cancer as noninvasive follicular Thyroid Neoplasm with papillary like nuclear features
    Surgery, 2018
    Co-Authors: Rajshri Mainthia, Peter M Sadow, Heather Wachtel, Yufei Chen, Elizabeth Mort, Sareh Parangi, Carrie C Lubitz
    Abstract:

    Background The reclassification of noninvasive encapsulated follicular variant of papillary Thyroid cancer to noninvasive follicular Thyroid Neoplasm with papillary-like nuclear features will reduce nonefficacious and potentially harmful care. Reclassification is estimated in 18.6% of patients with papillary Thyroid carcinoma; we aimed to quantify the implications of this change. Methods Pathology reports from April 2006 to April 2016 were reviewed to isolate cases that would have been designated as Neoplasm with papillary-like nuclear features. Of the 1,335 cases of papillary Thyroid carcinomas, 194 cases (14.5%) met criteria. Cases in which Neoplasm with papillary-like nuclear features was found in combination with other Thyroid malignancies (n = 25) and cases of prior Thyroid lobectomy (n = 5) were excluded. Demographic, pathologic, treatment, and follow-up data were assessed for the remaining 164 potential Neoplasm with papillary-like nuclear features cases. Logistic regression analysis was performed to evaluate association between fine-needle aspiration result and index procedure. Results Of the 164 patients with tumors who met Neoplasm with papillary-like nuclear features criteria, fine-needle aspiration results were nondiagnostic (2%), benign (18%), atypia/follicular lesion of undetermined significance (26%), follicular Neoplasm or suspicious for follicular Neoplasm (20%), suspicious for malignancy (19%), malignant (6%), and not obtained (9%). Eighty-five (52%) patients underwent total Thyroidectomy. A “suspicious for malignancy” fine-needle aspiration result was associated with undergoing total Thyroidectomy versus Thyroid lobectomy (P = .006). Thyroid lobectomy was the index procedure for 79 patients (48%); of these patients, 54% (n = 43, 3.2% of all patients with papillary Thyroid carcinomas) underwent subsequent total Thyroidectomy, and 24% received postoperative radioactive iodine treatment. There were no recurrences among the 125 patients with >3 months of follow-up. Conclusion The reclassification of noninvasive encapsulated follicular variant of papillary Thyroid cancer as Neoplasm with papillary-like nuclear features will decrease nonefficacious treatment and reduce costs. However, the impact of this change with regard to extent of surgery was limited to 3.2% of patients with papillary Thyroid carcinomas compared with the projected potential impact on 18.6%.

Yuri E Nikiforov - One of the best experts on this subject based on the ideXlab platform.

  • ahns series do you know your guidelines ahns endocrine section consensus statement state of the art Thyroid surgical recommendations in the era of noninvasive follicular Thyroid Neoplasm with papillary like nuclear features
    Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2018
    Co-Authors: Robert L Ferris, Yuri E Nikiforov, David J Terris, Raja R Seethala, Andrew J Ridge, Peter Angelos, Richard J Wong, Mona M Sabra, James A Fagin, Bryan Mciver
    Abstract:

    Author(s): Ferris, Robert L; Nikiforov, Yuri; Terris, Davis; Seethala, Raja R; Ridge, J Andrew; Angelos, Peter; Duh, Quan-Yang; Wong, Richard; Sabra, Mona M; Fagin, James A; McIver, Bryan; Bernet, Victor J; Harrell, R Mack; Busaidy, Naifa; Cibas, Edmund S; Faquin, William C; Sadow, Peter; Baloch, Zubair; Shindo, Maisie; Orloff, Lisa; Davies, Louise; Randolph, Gregory W | Abstract: The newly introduced pathologic diagnosis of noninvasive follicular Thyroid Neoplasm with papillary-like nuclear features (NIFTP) will result in less bilateral Thyroid surgery as well as deescalation in T4 suppressive and radioactive iodine treatment. Although, NIFTP is a nonmalignant lesion that has nuclear features of some papillary malignancies, the challenge for the surgeon is to identify a lesion as possibly NIFTP before the pathologic diagnosis. NIFTP, due to its reduction of overall rates of malignancy, will result in the initial surgical pendulum swinging toward lobectomy instead of initial total Thyroidectomy. This American Head and Neck Society endocrine section consensus statement is intended to inform preoperative evaluation to attempt to identify those patients whose final pathology report may ultimately harbor NIFTP and can be offered a conservative surgical plan to assist in cost-effective, optimal management of patients with NIFTP.

  • ahns series do you know your guidelines ahns endocrine section consensus statement state of the art Thyroid surgical recommendations in the era of noninvasive follicular Thyroid Neoplasm with papillary like nuclear features
    Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2018
    Co-Authors: Robert L Ferris, Yuri E Nikiforov, David J Terris, Raja R Seethala, Andrew J Ridge, Peter Angelos, Richard J Wong, Mona M Sabra, Quanyang Duh, James A Fagin
    Abstract:

    The newly introduced pathologic diagnosis of noninvasive follicular Thyroid Neoplasm with papillary-like nuclear features (NIFTP) will result in less bilateral Thyroid surgery as well as deescalation in T4 suppressive and radioactive iodine treatment. Although, NIFTP is a nonmalignant lesion that has nuclear features of some papillary malignancies, the challenge for the surgeon is to identify a lesion as possibly NIFTP before the pathologic diagnosis. NIFTP, due to its reduction of overall rates of malignancy, will result in the initial surgical pendulum swinging toward lobectomy instead of initial total Thyroidectomy. This American Head and Neck Society endocrine section consensus statement is intended to inform preoperative evaluation to attempt to identify those patients whose final pathology report may ultimately harbor NIFTP and can be offered a conservative surgical plan to assist in cost-effective, optimal management of patients with NIFTP.

  • Change in Diagnostic Criteria for Noninvasive Follicular Thyroid Neoplasm With Papillarylike Nuclear Features.
    JAMA oncology, 2018
    Co-Authors: Yuri E Nikiforov, Raja R Seethala, Zubair W. Baloch, Steven P. Hodak, Thomas J. Giordano, Ricardo V. Lloyd, Bruce M. Wenig
    Abstract:

    This review of medical literature examines the criteria for diagnosis of noninvasive follicular Thyroid Neoplasm with papillarylike nuclear features.

  • an international interobserver variability reporting of the nuclear scoring criteria to diagnose noninvasive follicular Thyroid Neoplasm with papillary like nuclear features a validation study
    Endocrine Pathology, 2018
    Co-Authors: Lester D R Thompson, Yuri E Nikiforov, Kennichi Kakudo, David N Poller, Raoul Burchette, Raja R Seethala
    Abstract:

    The aim of the study was to assess interobserver variation in reporting nuclear features of encapsulated follicular variant of papillary Thyroid carcinoma, newly reclassified as noninvasive follicular Thyroid Neoplasm with papillary-like nuclear features (NIFTP), based on a proposed standardized scoring system. An education module was individually reviewed as a pre-evaluation teaching guide of the specific features of classical papillary carcinoma, the specific inclusion and exclusion features for the diagnosis of NIFTP, and a catalog of the standardized scoring system of the nuclear features of papillary carcinoma used to reach this diagnosis. Participants subsequently reviewed 30 cases of Thyroid lesions previously scored by members of the Endocrine Pathology Society Working Group for the Re-evaluation of the Encapsulated Follicular Variant of Papillary Thyroid Carcinoma. There was one uninvolved reference image to demonstrate fixation, processing, and cell size and one image from each case for scoring, with results recorded for each participant. The location of training (country and program), years as a practicing pathologist, and approximate number of Thyroid gland surgical cases diagnosed per year were recorded. The degree of agreement between participants was assessed by kappa statistics, using the individual criteria and the average composite scores of the Working Group as a point of comparison. Using the Nuclear Standardized Scoring System, the interobserver agreement for final diagnosis score was generally excellent: unweighted and weighted kappa values between individual observers ranging from 0.242 to 0.930 (average 0.626). There was significant agreement between observers in reaching an interpretation of the presence or absence of nuclear features to diagnose NIFTP (score 0-1 versus score of 2-3), with California pathologists, 0.63 (median 0.66, SD 0.15); Japanese pathologists, 0.64 (median 0.66, SD 0.16); and UK pathologists, 0.60 (median 0.57, SD 014) compared to the expert panel, 0.70 (median 0.73, SD 0.19). The use of the nuclear scoring system to evaluate the nuclear features of papillary Thyroid carcinoma as applied to reach the diagnosis of NIFTP shows a good to substantial interobserver agreement, suggesting that consensus can be reached in diagnosing the nuclear features required for this newly reclassified Neoplasm.

  • noninvasive follicular Thyroid Neoplasm with papillary like nuclear features a review for pathologists
    Modern Pathology, 2018
    Co-Authors: Raja R Seethala, Yuri E Nikiforov, Giovanni Tallini, Peter M Sadow, Zubair W. Baloch, Justine A Barletta, Elham Khanafshar, Ozgur Mete, Virginia A Livolsi, Lester D R Thompson
    Abstract:

    Noninvasive follicular Thyroid Neoplasm with papillary-like nuclear features: a review for pathologists

Chan Kwon Jung - One of the best experts on this subject based on the ideXlab platform.

  • a multi institutional study of prevalence and clinicopathologic features of non invasive follicular Thyroid Neoplasm with papillary like nuclear features niftp in korea
    Journal of pathology and translational medicine, 2019
    Co-Authors: Ja Yeong Seo, Chan Kwon Jung, Ji Hyun Park, So Yeon Park, Ju Yeon Pyo, Yoon Jin Cha, Dong Eun Song, Jeong Ja Kwak, Janghee Kim, Jae Yeon Seok
    Abstract:

    Background In the present multi-institutional study, the prevalence and clinicopathologic characteristics of non-invasive follicular Thyroid Neoplasm with papillary-like nuclear features (NIFTP) were evaluated among Korean patients who underwent Thyroidectomy for papillary Thyroid carcinoma (PTC). Methods Data from 18,819 patients with PTC from eight university hospitals between January 2012 and February 2018 were retrospectively evaluated. Pathology reports of all PTCs and slides of potential NIFTP cases were reviewed. The strict criterion of no papillae was applied for the diagnosis of NIFTP. Due to assumptions regarding misclassification of NIFTP as non-PTC tumors, the lower boundary of NIFTP prevalence among PTCs was estimated. Mutational analysis for BRAF and three RAS isoforms was performed in 27 randomly selected NIFTP cases. Results The prevalence of NIFTP was 1.3% (238/18,819) of all PTCs when the same histologic criteria were applied for NIFTP regardless of the tumor size but decreased to 0.8% (152/18,819) when tumors ≥1 cm in size were included. The mean follow-up was 37.7 months and no patient with NIFTP had evidence of lymph node metastasis, distant metastasis, or disease recurrence during the follow-up period. A difference in prevalence of NIFTP before and after NIFTP introduction was not observed. BRAFV600E mutation was not found in NIFTP. The mutation rate for the three RAS genes was 55.6% (15/27). Conclusions The low prevalence and indolent clinical outcome of NIFTP in Korea was confirmed using the largest number of cases to date. The introduction of NIFTP may have a small overall impact in Korean practice.

  • interobserver and intraobserver variation in the morphological evaluation of noninvasive follicular Thyroid Neoplasm with papillary like nuclear features in asian practice
    Pathology International, 2019
    Co-Authors: Zhiyan Liu, Chan Kwon Jung, Andrey Bychkov, Mitsuyoshi Hirokawa, Shaofeng Sui, Soon Won Hong, Chiungru Lai, Deepali Jain, Sule Canberk
    Abstract:

    To evaluate the current diagnostic criteria in reporting nuclear features of noninvasive follicular Thyroid Neoplasm with papillary-like nuclear features (NIFTP), nine Asian pathologists with expertise in Thyroid reviewed virtual slides of 30 noninvasive follicular patterned Thyroid lesions according to the nuclear scoring system originally proposed by an international expert and a more detailed scoring system proposed by the Asian Working Group. The interobserver agreement for nuclear grading score was generally moderate (kappa value = 0.452). The best consistency fell on the chromatin features (kappa value = 0.658-1.000). A fair to moderate interobserver agreement was demonstrated in the evaluation of nuclear elongation, nuclear overlapping, membrane irregularities and distribution of papillary Thyroid carcinoma (PTC) type nuclear features. A slight agreement was rendered for the evaluation of the nuclear enlargement. Intraobserver agreement was substantial to perfect when comparing results of both scoring systems. However, both scoring systems were not able to reliably separate NIFTP from an encapsulated follicular variant PTC with minimal lymph node metastasis or BRAFV600E mutation. Although the three-point nuclear scoring system for the diagnosis of NIFTP is widely used in Asian practice, interobserver variation was considerable. Ancillary immunohistochemical or molecular testing might be helpful in differentiating NIFTP from true PTC.

  • clinical impact of non invasive follicular Thyroid Neoplasm with papillary like nuclear features on the risk of malignancy in the bethesda system for reporting Thyroid cytopathology a meta analysis of 14 153 resected Thyroid nodules
    Endocrine Practice, 2019
    Co-Authors: Huy Gia Vuong, Kennichi Kakudo, Chan Kwon Jung, Thao T K Tran, Andrey Bychkov, Tadao Nakazawa, Ryohei Katoh, Tetsuo Kondo
    Abstract:

    ABSTRACT Objective: It is still controversial as to how the reclassification of noninvasive follicular Thyroid Neoplasm with papillary-like nuclear features (NIFTP) affects the risk of malignancy (...

  • noninvasive follicular Thyroid Neoplasm with papillary like nuclear features in asian practice perspectives for surgical pathology and cytopathology
    Endocrine Pathology, 2018
    Co-Authors: Andrey Bychkov, Chan Kwon Jung, Zhiyan Liu, Kennichi Kakudo
    Abstract:

    The introduction of noninvasive follicular Thyroid Neoplasm with papillary-like nuclear features (NIFTP) was initiated and promoted by pathologists. Recent Asian studies added new knowledge to the existing literature to aid a better understanding of NIFTP. Our original data and the results of a meta-analysis suggest that the initial rate of NIFTP has been overestimated, averaging 9.1% (95% confidence interval [CI] 6.0-12.7%) of all papillary Thyroid cancers worldwide. The incidence of NIFTP in the Asian population (1.6%, 95% CI 0.9-2.5%; 7 studies) is significantly lower than that reported in the non-Asian series (13.3%, 95% CI 9.0-18.3%; 18 studies). Such difference could be attributed to various perceptions of histological diagnostic thresholds, different nature of papillary Thyroid carcinoma, and different approaches in the management of Thyroid nodules. The active surveillance for indeterminate nodules and NIFTP, largely represented in the indeterminate cytologic categories, promoted by Japanese institutions establishes a new paradigm to reduce overtreatment of these patients. The lower prevalence of NIFTP in the Asian series indicates a low impact on the risk of malignancy in cytopathology, as it was demonstrated in our original multi-institutional cohort of Thyroid nodules, and may predict a low impact on the performance of commercial molecular tests. Several Korean studies addressed the issue of BRAF mutation in NIFTP, which prompted the current refinement of the diagnostic criteria for NIFTP. Our survey of Asian pathologists found that the term NIFTP has not been universally adopted in the local practice. Endocrine pathologists must promote the new entity through provision of educational activities.

  • impact of non invasive follicular Thyroid Neoplasm with papillary like nuclear features on the bethesda system for reporting Thyroid cytopathology a multi institutional study in five asian countries
    Pathology, 2018
    Co-Authors: Andrey Bychkov, Chan Kwon Jung, Soon Won Hong, Deepali Jain, Shipra Agarwal, Somboon Keelawat, Shinya Satoh, Kennichi Kakudo
    Abstract:

    Summary Several Western studies showed that the recent introduction of non-invasive follicular Thyroid Neoplasm with papillary-like nuclear features (NIFTP) significantly decreased risk of malignancy for cytological diagnostic categories. We aimed to determine the impact of NIFTP on risk of malignancy within a cohort of Thyroid nodules from Asian countries, and to compare distribution of diagnostic categories between NIFTP and invasive encapsulated follicular variant of papillary Thyroid carcinoma (eFV-PTC). Consecutive Thyroid fine-needle aspirates from six institutions were retrospectively analysed. Histopathology slides with a diagnosis of eFV-PTC were reviewed and reclassified into invasive eFV-PTC and NIFTP. The risk of malignancy was calculated with and without NIFTP. Of 11,372 Thyroid nodules, 2044 had available surgical follow-up. NIFTP was diagnosed in 59 cases, which constituted 2.9% of all excised nodules, and 5.3% of malignant nodules. Preoperative cytological diagnoses for NIFTP were non-diagnostic (10.2%), benign (18.6%), atypia of undetermined significance/follicular lesion of undetermined significance (22.0%), follicular Neoplasm/suspicious for follicular Neoplasm (FN/SFN) (32.2%), suspicious for malignancy (SM) (11.9%), and malignant (5.1%). The only category which showed a relative reduction in risk of malignancy after reclassification of more than 20%, was FN/SFN (24.4%). There was a significantly higher prevalence of benign cytology in NIFTP (p = 0.04) and SM/malignant in invasive eFV-PTC (p = 0.05). A majority of NIFTP cases were classified in indeterminate categories, which decreased the corresponding risk of malignancy. However, the magnitude of NIFTP impact was much lower than in the Western reports. Asian countries may not experience significant effects of NIFTP reclassification on the practice of Thyroid cytopathology.

Raja R Seethala - One of the best experts on this subject based on the ideXlab platform.

  • ahns series do you know your guidelines ahns endocrine section consensus statement state of the art Thyroid surgical recommendations in the era of noninvasive follicular Thyroid Neoplasm with papillary like nuclear features
    Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2018
    Co-Authors: Robert L Ferris, Yuri E Nikiforov, David J Terris, Raja R Seethala, Andrew J Ridge, Peter Angelos, Richard J Wong, Mona M Sabra, James A Fagin, Bryan Mciver
    Abstract:

    Author(s): Ferris, Robert L; Nikiforov, Yuri; Terris, Davis; Seethala, Raja R; Ridge, J Andrew; Angelos, Peter; Duh, Quan-Yang; Wong, Richard; Sabra, Mona M; Fagin, James A; McIver, Bryan; Bernet, Victor J; Harrell, R Mack; Busaidy, Naifa; Cibas, Edmund S; Faquin, William C; Sadow, Peter; Baloch, Zubair; Shindo, Maisie; Orloff, Lisa; Davies, Louise; Randolph, Gregory W | Abstract: The newly introduced pathologic diagnosis of noninvasive follicular Thyroid Neoplasm with papillary-like nuclear features (NIFTP) will result in less bilateral Thyroid surgery as well as deescalation in T4 suppressive and radioactive iodine treatment. Although, NIFTP is a nonmalignant lesion that has nuclear features of some papillary malignancies, the challenge for the surgeon is to identify a lesion as possibly NIFTP before the pathologic diagnosis. NIFTP, due to its reduction of overall rates of malignancy, will result in the initial surgical pendulum swinging toward lobectomy instead of initial total Thyroidectomy. This American Head and Neck Society endocrine section consensus statement is intended to inform preoperative evaluation to attempt to identify those patients whose final pathology report may ultimately harbor NIFTP and can be offered a conservative surgical plan to assist in cost-effective, optimal management of patients with NIFTP.

  • ahns series do you know your guidelines ahns endocrine section consensus statement state of the art Thyroid surgical recommendations in the era of noninvasive follicular Thyroid Neoplasm with papillary like nuclear features
    Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2018
    Co-Authors: Robert L Ferris, Yuri E Nikiforov, David J Terris, Raja R Seethala, Andrew J Ridge, Peter Angelos, Richard J Wong, Mona M Sabra, Quanyang Duh, James A Fagin
    Abstract:

    The newly introduced pathologic diagnosis of noninvasive follicular Thyroid Neoplasm with papillary-like nuclear features (NIFTP) will result in less bilateral Thyroid surgery as well as deescalation in T4 suppressive and radioactive iodine treatment. Although, NIFTP is a nonmalignant lesion that has nuclear features of some papillary malignancies, the challenge for the surgeon is to identify a lesion as possibly NIFTP before the pathologic diagnosis. NIFTP, due to its reduction of overall rates of malignancy, will result in the initial surgical pendulum swinging toward lobectomy instead of initial total Thyroidectomy. This American Head and Neck Society endocrine section consensus statement is intended to inform preoperative evaluation to attempt to identify those patients whose final pathology report may ultimately harbor NIFTP and can be offered a conservative surgical plan to assist in cost-effective, optimal management of patients with NIFTP.

  • Change in Diagnostic Criteria for Noninvasive Follicular Thyroid Neoplasm With Papillarylike Nuclear Features.
    JAMA oncology, 2018
    Co-Authors: Yuri E Nikiforov, Raja R Seethala, Zubair W. Baloch, Steven P. Hodak, Thomas J. Giordano, Ricardo V. Lloyd, Bruce M. Wenig
    Abstract:

    This review of medical literature examines the criteria for diagnosis of noninvasive follicular Thyroid Neoplasm with papillarylike nuclear features.

  • an international interobserver variability reporting of the nuclear scoring criteria to diagnose noninvasive follicular Thyroid Neoplasm with papillary like nuclear features a validation study
    Endocrine Pathology, 2018
    Co-Authors: Lester D R Thompson, Yuri E Nikiforov, Kennichi Kakudo, David N Poller, Raoul Burchette, Raja R Seethala
    Abstract:

    The aim of the study was to assess interobserver variation in reporting nuclear features of encapsulated follicular variant of papillary Thyroid carcinoma, newly reclassified as noninvasive follicular Thyroid Neoplasm with papillary-like nuclear features (NIFTP), based on a proposed standardized scoring system. An education module was individually reviewed as a pre-evaluation teaching guide of the specific features of classical papillary carcinoma, the specific inclusion and exclusion features for the diagnosis of NIFTP, and a catalog of the standardized scoring system of the nuclear features of papillary carcinoma used to reach this diagnosis. Participants subsequently reviewed 30 cases of Thyroid lesions previously scored by members of the Endocrine Pathology Society Working Group for the Re-evaluation of the Encapsulated Follicular Variant of Papillary Thyroid Carcinoma. There was one uninvolved reference image to demonstrate fixation, processing, and cell size and one image from each case for scoring, with results recorded for each participant. The location of training (country and program), years as a practicing pathologist, and approximate number of Thyroid gland surgical cases diagnosed per year were recorded. The degree of agreement between participants was assessed by kappa statistics, using the individual criteria and the average composite scores of the Working Group as a point of comparison. Using the Nuclear Standardized Scoring System, the interobserver agreement for final diagnosis score was generally excellent: unweighted and weighted kappa values between individual observers ranging from 0.242 to 0.930 (average 0.626). There was significant agreement between observers in reaching an interpretation of the presence or absence of nuclear features to diagnose NIFTP (score 0-1 versus score of 2-3), with California pathologists, 0.63 (median 0.66, SD 0.15); Japanese pathologists, 0.64 (median 0.66, SD 0.16); and UK pathologists, 0.60 (median 0.57, SD 014) compared to the expert panel, 0.70 (median 0.73, SD 0.19). The use of the nuclear scoring system to evaluate the nuclear features of papillary Thyroid carcinoma as applied to reach the diagnosis of NIFTP shows a good to substantial interobserver agreement, suggesting that consensus can be reached in diagnosing the nuclear features required for this newly reclassified Neoplasm.

  • noninvasive follicular Thyroid Neoplasm with papillary like nuclear features a review for pathologists
    Modern Pathology, 2018
    Co-Authors: Raja R Seethala, Yuri E Nikiforov, Giovanni Tallini, Peter M Sadow, Zubair W. Baloch, Justine A Barletta, Elham Khanafshar, Ozgur Mete, Virginia A Livolsi, Lester D R Thompson
    Abstract:

    Noninvasive follicular Thyroid Neoplasm with papillary-like nuclear features: a review for pathologists

Zubair W. Baloch - One of the best experts on this subject based on the ideXlab platform.

  • noninvasive follicular Thyroid Neoplasm with papillary like nuclear features niftp update and diagnostic considerations a review
    Endocrine Pathology, 2019
    Co-Authors: Esther Diana Rossi, Zubair W. Baloch, Lester D R Thompson, Guido Fadda, Luigi Maria Larocca, William C Faquin, Liron Pantanowitz
    Abstract:

    Advances in our understanding of Thyroid lesions, especially those entities with an indolent behavior, has led clinicians to question the most appropriate surgical management of such Thyroid nodules. Several studies have shown that the non-invasive encapsulated follicular variant of papillary Thyroid carcinomas (NI-EFVPC) exhibits poor histopathologic diagnostic reproducibility and have been over-treated as conventional Thyroid cancer. In 2015, an international Thyroid working group re-evaluated NI-EFVPC and its diagnostic criteria. The new terminology of "noninvasive follicular Thyroid Neoplasm with papillary-like nuclear features" (NIFTP) was accordingly introduced to replace NI-EFVPC. The literature has emphasized that NIFTPs are biologically similar to follicular adenomas lacking lymph node metastases and/or recurrence. While the definition of NIFTP is based on specific morphological parameters, recent studies have questioned whether the criterion allowing less than 1% of true papillae should be revised to a total absence of papillae. The motivation for this revision is the rare finding, in some studies, of lymph nodes with metastatic NIFTP. This review evaluates the existing published series of NIFTP cases, clinical consequences of NIFTP, and emerging changes in the diagnostic criteria for NIFTP. The introduction of NIFTP has resulted in significant impact on the clinical management of Thyroid nodules. Recent revisions in the morphological criteria for NIFTP emphasize the need to adhere to very stringent histomorphologic criteria when making a diagnosis of NIFTP. The adoption of NIFTP terminology instead of NI-EFVPC is associated with conservative lobectomy without radioactive iodine treatment in the majority of cases.

  • papillary Thyroid microcarcinoma reclassification to non invasive follicular Thyroid Neoplasm with papillary like nuclear features niftp a retrospective clinicopathologic study
    Endocrine Pathology, 2018
    Co-Authors: Khurram Shafique, Virginia A Livolsi, Kathleen T Montone, Zubair W. Baloch
    Abstract:

    Papillary Thyroid microcarcinoma (PTMC) accounts for nearly 50% of newly diagnosed PTC cases. There is considerable debate in literature about the clinicopathologic features and prognostic significance of PTMC and whether it should be treated as a separate entity. Due to lack of agreement and supportive data, the consensus study group that established the criteria for non-invasive Thyroid Neoplasm with papillary-like features (NIFTP) kept its size above 1 cm i.e., excluding PTMC from this new group. As a result, to date, some patients diagnosed with PTMC get aggressive treatments such as partial or total Thyroidectomy and even radioactive iodine ablation. We retrospectively studied clinicopathologic features and long-term follow-up of 48 cases of papillary Thyroid microcarcinoma. Of these, 7 cases (15%) had capsular invasion, 2 cases (4%) had extraThyroidal extension, 1 case (2%) had lymphovascular invasion, 5 cases (25%) had lymph node metastases, no case (0%) had any distant metastases, and 1 case had recurrence after long-term follow-up (mean 13.7 years, range 1–21 years). Upon slide review, 8 cases fulfilled the criteria for NIFTP and were sub-classified under this new category. These 8 cases had no recurrence after long-term follow-up (mean 12.1 years, range 7–19 years). In this study, we confirmed the previous published reports exhibiting indolent nature of PTMC and also suggested that PTMC cases that fulfill all the criteria for NIFTP can be sub-classified under this term in order to avoid unnecessary aggressive treatment.

  • Change in Diagnostic Criteria for Noninvasive Follicular Thyroid Neoplasm With Papillarylike Nuclear Features.
    JAMA oncology, 2018
    Co-Authors: Yuri E Nikiforov, Raja R Seethala, Zubair W. Baloch, Steven P. Hodak, Thomas J. Giordano, Ricardo V. Lloyd, Bruce M. Wenig
    Abstract:

    This review of medical literature examines the criteria for diagnosis of noninvasive follicular Thyroid Neoplasm with papillarylike nuclear features.

  • noninvasive follicular Thyroid Neoplasm with papillary like nuclear features a review for pathologists
    Modern Pathology, 2018
    Co-Authors: Raja R Seethala, Yuri E Nikiforov, Giovanni Tallini, Peter M Sadow, Zubair W. Baloch, Justine A Barletta, Elham Khanafshar, Ozgur Mete, Virginia A Livolsi, Lester D R Thompson
    Abstract:

    Noninvasive follicular Thyroid Neoplasm with papillary-like nuclear features: a review for pathologists

  • Noninvasive follicular Thyroid Neoplasm with papillary-like nuclear features: a review for pathologists
    Modern Pathology, 2018
    Co-Authors: Raja R Seethala, Yuri E Nikiforov, Giovanni Tallini, Peter M Sadow, Zubair W. Baloch, Justine A Barletta, Elham Khanafshar, Ozgur Mete, Virginia A Livolsi, Lester D R Thompson
    Abstract:

    The rising incidence of papillary Thyroid carcinoma is linked in part to inclusion of noninvasive follicular variant of papillary Thyroid carcinoma. Despite its designation as carcinoma , noninvasive follicular variant of papillary Thyroid carcinoma appears to be exceptionally indolent, often over treated by current treatment practices. Additionally, criteria for diagnosis have historically been subjective and challenging. Recently, an international multidisciplinary collaborative group performed a clinicopathologic survey of such cases with extended follow-up and concluded based on the outcome data that a revision in nomenclature was warranted, proposing ‘Noninvasive Follicular Thyroid Neoplasm with Papillary-like Nuclear Features (NIFTP).’ This monograph is a synopsis and guide for pathologists on NIFTP and focuses on histologic features, including inclusion and exclusion criteria used to define NIFTP, as well as grossing guidelines, reporting practices, and potential diagnostic limitations.